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Cachexia, or muscle wasting, is a common problem associated with many underlying disease processes, including rheumatoid arthritis (RA). If you are ready to try and combat cachexia, you can improve basic functioning or increase strength by making simple changes.
Up Your Protein
Discuss with your doctor the prospect of adopting a high-protein diet. Unless you have a predisposition to kidney problems, you should be able to eat more protein safely. Depending on your current diet, start with making sure you eat 1g of protein for every kg of body weight. If you are going to increase one of your macros, you likely need to decrease another to prevent eating too many calories each day. Ideally, you should decrease your carbohydrate intake and keep your intake of healthy fats either moderate or high, depending on your dietary preferences and needs. If you do not notice any improvements, you may need more protein, with some people consuming upwards of 1.5g/kg of body weight. To make the intake of higher protein easier, you might want to include protein supplements. Look for low or no-carb varieties. Vanilla or unflavored protein powder is easily incorporated in your morning coffee or as a meal replacement.
One supplement that is especially beneficial for cachexia is beta-hydroxy beta-methylbutyric acid (HMB). Again, it is critical to speak with your doctor before integrating any new supplements just to be certain there are no interactions with your medications. HMB can help increase muscle mass when combined with strength training and increased protein. For people who currently weight train, it also helps with muscle recovery. The general recommended dosage is 3g-6g per day. Start with 3g and divide-up the total amount so you take some with each meal. You might also consider integrating branched-chain amino acids (BCAA), which is frequently used in the fitness community after workouts to help with building muscle. BCAAs are especially useful if you have difficulties consuming enough protein throughout the day to facilitate rebuilding lost muscle.
Start Strength Training
Eating more protein and supplementing will do little if you do not challenge your muscles. The easiest way to start rebuilding your muscles is to increase the intensity of any strength training activity you already do. For people who face significant limitations due to RA, adding ankle or wrist weights, or a weighted vest might help. As long as these items do not cause unnecessary pain to already-affected joints, they should be fine to use. Adding a little extra weight while you go about your daily tasks is one way of forcing your muscles to work a little harder and the extra weight will also increase your calorie burn, which can be helpful if you struggle with excess weight. Whenever you are up to the challenge, use resistance bands to perform different exercises. Resistance bands with straps for handles are easier to use if you have problems with your hands. You can generally allow the strap to rest across your palm, instead of gripping them.
Regaining lost muscle from RA or other chronic diseases is often a slow and tedious process. With the right nutrition and slowly building your strength, you can make steady progress toward improving functional fitness.